What Is the Best Marker of Physical Well-Being?

A decade ago, my wife worked as a research assistant for a researcher studying obesity. The research team met once per week to brainstorm ideas. They were planning a study to test the urban myth that the average college student puts on 15 pounds of grizzle during their first year away from home [insert image of a 15-pound dumbbell stapled to the hip of a teenager]. Is parental supervision replaced by a ubiquitous beer helmet while strolling through campus (one straw from two beer cans for convenient hands-free alcohol delivery). The study was nearly ready to go when my wife asked a simple question, "I might be missing something but why are we ignoring the summer between the end of high school and start of college? A number of kids probably gain weight while they are partying their asses off before classes begin." Everyone in the meeting turned to my wife in astonishment....of course! brilliant! you saved the study!

The lesson? Scientists have to spend time out of their heads and inside the real-world. One of many reasons I turn to my wife to shoot holes in my ideas.

Everyone gets excited about scientific studies with unusual, expensive measures of physical health. Natural Killer T counts when confronted by life stressors (a marker of immunological functioning). Greater activity in the the left compared to the right dorsolateral prefrontal cortex (a marker of tendencies to approach the world in search of rewards instead of withdrawing from the world to avoid threats). But what is the best marker of physical health? What is the best way to tell whether a person reached their genetic potential?

The answer is simple, obvious, and neglected: height. As a child grows in physical stature, we know that the rest of them is growing and maturing as well. As our children get taller, we know that their brain is growing and maturing. This is good. If you look across the past few centuries, you will find that the average height of men and women has systematically increased. If you look at countries where there has been continual poverty, a lack of nutritious food, and unsanitary conditions, you can find stagnation or even declining height in the population. Height, a simple metric, is a powerful gauge of economic progress.

In Britain and the United States, people's height at age 3 is strongly related to height in adulthood (correlations greater than .70 for both men and women). Also, height is strongly linked to scores on tests of intelligence (or executive functioning). Thus, height offers a portal to physical health, a window into whether someone missed reaching their genetic potential. Height is an excellent marker of what happened during development whether it is the nutrition received or mental and physical health during childhood and adolescence.

Like every measure of health or well-being, height is an imperfect measure. And if you are going to use height as a gauge of genetic potential then obviously you must account for the genetic contributions of parents (and even grandparents) in terms of their height.

As parents, we want is for our children to have an opportunity to reach their potential. As scientists, sometimes it is useful to forgo complexity for accuracy and simplicity. If we want to raise the well-being of people around the globe, let's not forget the basics of dealing with prenatal maternal stress, nutritious meals, and clean water. Psychology cannot be divorced from biology. Changes in height from one generation to the next will offer a hint of whether we are moving in the right direction with our interventions.

Height as a factor of physical health? But you seem to indicate more of a correlation between height and mental ability.

Also, is this just a random observation you're commenting on? Because I know that correlations definitely do not equal causation.

For example, during a hypothetical summer, sales of ice cream and deaths by drowning both increase. (correlation) However if you outlawed ice cream deaths by drowning would see similar numbers during other hypothetical summers, as the two pretty clearly have relatively little to do with each other. (Not a causation)

So, it could be that you're right. Or it could be as we put more and more growth hormones into livestock our populace generally gets larger as a result from consuming the meat which still contains said growth hormones. Is that not also a possibility?

No, it is not a random observation. I could cite dozens of studies examining birth cohorts over time with cross-lagged panel designs but this is a blog not a scientific article. Let me know if you can't find the references from the U.S., Britain, and Australia from Google Scholar or if you are at a university, your library.

and yes, height is an index of physical health. The origin of executive functioning is a healthy physical body during critical phases of development. Height is an index of healthy maturation and growth.

Your comment about growth hormones has to deal with the data showing changes in height from one generation to the next before synthetic hormones were ubiquitous in farming.

but yes, you are right, correlation does not equal causation. But we cannot be rigid about this. Sometimes data converge from multiple methods, sampling strategies, and sound theoretical frameworks to point in one direction more than another. Let me give you a concrete example. What if we found a consistently positive correlation between having a college education with the willingness to engage in adventurous sexual activity such as orgies and sadomasochism (which by the way, there are data that fit this example). The notion that being a sadist, masochist, and wrapping yourself in rubber before being humiliated by your partner in order to be sexually aroused leads you to get into college is far less convincing than the other direction. That is, during the college years, people experiment with a ton of different behaviors in their little bubble of a universe. Fits with the data showing that binge drinking increases dramatically during college and then almost drops off completely in the year after graduating.

Thus, the correlation does not equal causation mantra should be held loosely based on a close look at all the available data and existing conceptual models.

nothing random here. Not that there is anything wrong with randomness.

Mr. or Ms. Anonymous, I'm sorry that this was your only take away message. You missed the nuances and the primary discussion of trying to help people reach their genetic potential. Some people are going to be shorter or heavier than others based on their genetic range. Read it again and you will that this is not about discriminating against people, its about understanding the biology that affects our physical and mental maturation.

I think this would have been a more edifying article if you had made it clearer that just because a certain height and positive health characteristics correlate does not mean that height automatically equals health. There are other factors at work, particularly genetics irrelevant to overall health. This also should have been addressed in your writing in more than just one throwaway sentence.

More specifics than just the .70 ratio between three-year-old and adult height would also have made this piece more informative.

Also, if you will forgive me a little reductio ad absurdum, Robert Pershing Wadlow was the tallest recorded human at 8 feet 11 inches, and he also had terrible health through much of his adult life, partially due to complications from acromegaly (which also caused his height, hence my self-confession of reductio ad absurdum).

Even so, Billy Barty, who never topped four feet tall, lived to be 76 with no ill effects.

I stand five feet six inches myself, but expect a shorter life span not due to height, which by the way is genetic, not a result of the factors you specified, but because both sides of my family have a history of heart disease and hypertension.

On a more pedantic note, "grizzle" should be "gristle" in your first long paragraph, and the next sentence should end in a question mark.

As things stand, I would leave the height issue out of the abstract for this piece, and focus on the effectiveness of simplicity. However, given the ineffectiveness of generalizations regarding height and health as presented, this article would be most effective if a better example of simplicity in research thinking were presented, and the article rewritten completely around the new example.

thanks for the editing. You have some good points and then you fall prey to what you are criticizing me about. Using the two most extreme examples for height at the high and low end fail to provide useful information about the relationship between height and health. This is what scientists refer to as outliers.

Yes, there are other contributors to health than height. Wouldn't you say the same thing about anything related to health? What could anyone possibly write about that wouldn't lead to your same criticism (i.e., there are other factors)? Nothing explains 100% of the variance in health related outcomes.

You are entitled to your opinions but not the data. Check out the available evidence on height and health across generations or cohorts. Easily available by google scholar. This is not a scientific review of the available empirical literature. This is an 800 word blog post. Let me know if you want references. Just tell me what types of studies you are interested in.

The existing data suggest that height is a useful metric to capture whether people reach their genetic potential. You disagree. Your don't think height is a valid indicator of healthy maturation and growth. From what you wrote, this is because there is an imperfect relationship between the two (i.e., there are people that are tall that have poor health and people that are short that have good health). You are a stickler for rigid grammatical structure (note: the word grizzle was used intentionally and playfully). Points taken.

I agree that this is an effective summary of where we respectively stand, though I am curious how a word like "grizzle" can be used playfully. There aren't that many contexts outside the phrase "grizzled veteran" where it can really be used correctly on purpose.

I also submit that a complete summary of my viewpoint is that the originator of a topic is responsible ultimately for supporting his or her viewpoint--or indeed, clearly expressing it in the first place. I mean, other than the uncited ratio specified in the piece, I'm uncertain even of the correlation, much less any argued causation, between height and health. Again, I'm short, but I think this has a lot less to do with my own personal longevity than my family's history of heart and blood ailments.

Plus, there's still the fact that height extremes in either direction can suggest bad health. This is why I urged you to describe the relationship more clearly. It's obviously not linear--but what's the curve? Is it a bell? A simple parabola? What heights are optimum...AND WHY?

As far as my strict grammatical standards: informality can be used for dramatic effect quite well without diminishing the quality of one's writing. Knowledge of standard grammar is essential, however, to avoid the perception of laziness, which looks bad even in a blog.

Your rigid standards for grammar seem to extend to rigid standards for how someone with a Ph.D. is supposed to behave (no slang words!). Make sure you don't read my other blog posts as I do use occasional profanity (very inappropriate for an adult with a Ph.D.).

Nonetheless, I respect your highly intense interest to set the record straight. Thus, here are two articles to satisfy your curiosity about height and health. Enjoy!

I expect the correlation between height and health breaks down when a person exceeds a certain stature as the effects of probable pituitary tumors and musculo-skeletal problems faced by very tall individuals begin to take their toll.

Many other physical measures could be taken as a proxy for well being. What makes height a better measure than things like bilateral symmetry or skin clarity?

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This is not the kind of thing you should pursue on your own!! Your supplements, and your health status, reflected by things such as lab reports absolutely should be supervised by a health care provider, whether that person is an MD, or an alternative health provider, such as a naturopath.
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